<%@include file="inc/prelude.jsp" %>
<div id="wrapper">
    <%@include file="inc/header.jsp" %>
    <%@include file="inc/menu.jsp" %>
    <div id="content">
        <div class="content-left">
            <form method="POST" action="enroll_bill.htm" name="add_bill_form"> 
                <div id="table-mess">
                    <s:actionerror />
                    <div class="mess">
                        <div class="mess-title">
                            <img src="${pageContext.request.contextPath}/res/images/star.png" border="0">
                            <s:text name="user.add_bill.head" />
                        </div>
                        <div class="clearboth"></div>
                        <div class="mess-content">
                            <table>
                                <tr>
                                    <td style="font-weight: bold;"><s:text name="user.add_bill.biller" /></td>
                                    <td>:</td>
                                    <td>
                                        <s:select name="biller" list="allServices" listKey="id" listValue="serviceName"/>
                                    </td>
                                </tr>
                                <tr>
                                    <td style="font-weight: bold;"><s:text name="user.add_bill.accno" /></td>
                                    <td>:</td>
                                    <td>
                                        <s:textfield name="accNo"/>                                        
                                    </td>
                                </tr>
                                <tr>
                                    <td style="font-weight: bold;"><s:text name="user.add_bill.accname" /></td>
                                    <td>:</td>
                                    <td>
                                        <s:textfield name="accName"/>                                                                                
                                    </td>
                                </tr>
                                <tr>
                                    <td style="font-weight: bold;"><s:text name="user.add_bill.address" /></td>
                                    <td>:</td>
                                    <td>
                                        <s:textfield name="address"/>                                        
                                    </td>
                                </tr>
                                <tr>
                                    <td colspan="3" style="text-align: center">
                                        <button type="submit">
                                            <s:text name="common.btn.submit" />
                                        </button>
                                        &nbsp;
                                        <button onclick="document.location='summary.htm';return false;">
                                            <s:text name="common.btn.cancel" />
                                        </button>
                                    </td>
                                </tr>
                            </table>
                        </div>
                        <div class="clearboth"></div>
                    </div>
                </div>
            </form>
            <%@include file="inc/quicklink.jsp" %>
        </div>
        <%@include file="inc/rightmenu.jsp" %>
    </div>
    <%@include file="inc/footer.jsp" %>
</div>
<%@include file="inc/coda.jsp" %>